title: Human papillomaviruses in oral carcinoma and oral potentially malignant disorders: a systematic review.
abstract: OBJECTIVE
  Human papillomavirus (HPV) in oral carcinoma (OSCC) and potentially malignant disorders (OPMD) is controversial. The primary aim was to calculate pooled risk estimates for the association of HPV with OSCC and OPMD when compared with healthy oral mucosa as controls. We also examined the effects of sampling techniques on HPV detection rates.
  
  
  METHODS
  Systematic review was performed using PubMed (January 1966-September 2010) and EMBASE (January 1990-September 2010). Eligible studies included randomized controlled, cohort and cross-sectional studies. Pooled data were analysed by calculating odds ratios, using a random effects model. Risk of bias was based on characteristics of study group, appropriateness of the control group and prospective design.
  
  
  RESULTS
  Of the 1121 publications identified, 39 cross-sectional studies met the inclusion criteria. Collectively, 1885 cases and 2248 controls of OSCC and 956 cases and 675 controls of OPMD were available for analysis. Significant association was found between pooled HPV-DNA detection and OSCC (OR = 3.98; 95% CI: 2.62-6.02) and even for HPV16 only (OR = 3.86; 95% CI: 2.16-6.86). HPV was also associated with OPMD (OR = 3.87; 95% CI: 2.87-5.21). In a subgroup analysis of OPMD, HPV was also associated with oral leukoplakia (OR = 4.03; 95% CI: 2.34-6.92), oral lichen planus (OR = 5.12; 95% CI: 2.40-10.93), and epithelial dysplasia (OR = 5.10; 95% CI: 2.03-12.80).
  
  
  CONCLUSIONS
  The results suggest a potentially important causal association between HPV and OSCC and OPMD.
authors.affiliation: Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland. stina.syrjanen@utu.fi
authors.forename: S
authors.initials: S
authors.lastname: Syrjänen
authors.forename: G
authors.initials: G
authors.lastname: Lodi
authors.forename: I
authors.initials: I
authors.lastname: von Bültzingslöwen
authors.forename: A
authors.initials: A
authors.lastname: Aliko
authors.forename: P
authors.initials: P
authors.lastname: Arduino
authors.forename: G
authors.initials: G
authors.lastname: Campisi
authors.forename: S
authors.initials: S
authors.lastname: Challacombe
authors.forename: G
authors.initials: G
authors.lastname: Ficarra
authors.forename: C
authors.initials: C
authors.lastname: Flaitz
authors.forename: H M
authors.initials: HM
authors.lastname: Zhou
authors.forename: H
authors.initials: H
authors.lastname: Maeda
authors.forename: C
authors.initials: C
authors.lastname: Miller
authors.forename: M
authors.initials: M
authors.lastname: Jontell
mesh_terms: D052685:Alphapapillomavirus / Q000502:physiology*; D015982:Bias; D002472:Cell Transformation, Viral; D015331:Cohort Studies; D035061:Control Groups; D003430:Cross-Sectional Studies; D006801:Humans; D009062:Mouth Neoplasms / Q000821:virology*; D030361:Papillomavirus Infections / Q000821:virology*; D011230:Precancerous Conditions / Q000821:virology*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors